Pace is on the record as supporting much of President Barack Obama’s health-care law, but he says he opposes the mandate that everyone buy insurance or pay a penalty. The Supreme Court upheld the law’s constitutionality based on the theory that the penalty for not buying insurance is a tax, although supporters dispute the “tax” label.

Many critics, including Tipton, have made the claim about $716 billion in cuts before. Obama’s law does not literally cut the Medicare budget, according to Politifact, a nonpartisan fact-checker. Instead, it seeks future savings by limiting the growth in payments to hospitals and insurance companies. Tipton twice voted for the same savings in the House Republican budget.

The claim about the 15 unelected bureaucrats refers to the Independent Payment Advisory Board. The board does not review individual patients. Instead, it recommends ways for the Medicare program to save money if Medicare spending grows too quickly. The board could not ration care, change benefits or raise taxes, according to the Kaiser Family Foundation.

The $1.3 million ad is easily the biggest ad purchase of the year. It more than triples all the money Pace’s campaign raised from July through September.